No significant difference in mean blood loss, incidence of PPH or the fall in Hb concentration. The need for additional oxytocic agents higher in misoprostol group (RR 1.62, 95% CI 1.34–1.96), although manual removal of placenta was reduced (RR 0.29, 95% CI 0.09–0.87). Here, GSTM1 is linked to pulmonary arterial hypertension.